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https://www.readbyqxmd.com/read/28416224/post-discharge-kidney-function-is-associated-with-subsequent-ten-year-renal-progression-risk-among-survivors-of-acute-kidney-injury
#1
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black
The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes...
April 14, 2017: Kidney International
https://www.readbyqxmd.com/read/28372579/va-residential-substance-use-disorder-treatment-program-providers-perceptions-of-facilitators-and-barriers-to-performance-on-pre-admission-processes
#2
Laura S Ellerbe, Luisa Manfredi, Shalini Gupta, Tyler E Phelps, Thomas R Bowe, Anna D Rubinsky, Jennifer L Burden, Alex H S Harris
BACKGROUND: In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics...
April 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28369754/association-of-physician-specialty-with-hospice-referral-for-hospitalized-nursing-home-patients-with-advanced-dementia
#3
Claire K Ankuda, Susan L Mitchell, Pedro Gozalo, Vince Mor, David Meltzer, Joan M Teno
OBJECTIVES: Hospitalists hospice referral patterns have been unstudied. This study aims to examine hospice referral rates by attending type for hospitalized nursing home (NH) residents with advanced cognitive impairment (ACI) at the time of discharge between 2000 and 2010. DESIGN: Retrospective cohort study. PARTICIPANTS: Hospitalized NH residents age ≥66 drawn from the 20% sample of Medicare beneficiaries with ACI, 4 or more activities of daily living (ADL) impairments on last minimum data set (MDS) assessment completed within 120 days of admission (n = 128,989)...
March 28, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28344160/pre-operative-predictors-of-poor-outcomes-in-patients-undergoing-surgical-lower-extremity-revascularisation-retrospective-cohort-study
#4
Mohammed Ashrafi, Rohini Salvadi, Philip Foden, Stephanie Thomas, Mohamed Baguneid
BACKGROUND: Surgical lower extremity revascularisation (LER) can lead to poor outcomes that include delayed hospital discharge, in-hospital mortality, major amputations and readmissions. The aim of this study was to identify pre-operative predictors associated with these poor clinical outcomes. MATERIALS AND METHODS: All patients (n = 635; mean age 69; male 67.4%) who underwent surgical LER over a 5 year period in a single tertiary vascular institution were identified...
March 23, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28293808/low-pre-operative-heart-rate-variability-and-complexity-are-associated-with-hypotension-after-anesthesia-induction-in-major-abdominal-surgery
#5
James R Padley, Erez Ben-Menachem
Significant hypotension after induction of general anesthesia is common and has the potential for serious complications. This study aimed to determine if pre-operative heart rate variability (HRV) was associated with post-induction hypotension in patients undergoing major abdominal surgery. Patients undergoing semi-elective major abdominal surgery were consecutively recruited during pre-admission clinic assessment. Exclusion criteria included cardiac conduction disease, arrhythmias or severe liver or renal disease...
March 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28282229/evaluation-of-the-safety-of-early-compared-to-late-enteral-nutrition-in-canine-septic-peritonitis
#6
Jamie Elizabeth Hoffberg, Amy Koenigshof
Septic peritonitis is a relatively common condition in the veterinary intensive care unit, with a classically high mortality rate. Early enteral nutrition (EEN) in critically ill humans can lead to improved outcome. This study was performed to determine the safety of early postoperative feeding in canine septic peritonitis. In this retrospective case series, 56 dogs were identified. Sixteen dogs received EEN, defined as nutrition within 24 hr of surgery; 27 received late enteral nutrition (LEN) defined as nutrition more than 24 hours following surgery; and 13 dogs had no enteral nutrition in hospital (NEN)...
March 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28265730/does-beta-blockade-reduce-the-risk-of-depression-in-patients-with-isolated-severe-extracranial-injuries
#7
Rebecka Ahl, Galinos Barmparas, Louis Riddez, Eric J Ley, Göran Wallin, Olle Ljungqvist, Shahin Mohseni
BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury. METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28254961/impact-of-pre-admission-depression-on-mortality-following-myocardial-infarction
#8
Jens Sundbøll, Morten Schmidt, Kasper Adelborg, Lars Pedersen, Hans Erik Bøtker, Poul Videbech, Henrik Toft Sørensen
BackgroundThe prognostic impact of previous depression on myocardial infarction survival remains poorly understood.AimsTo examine the association between depression and all-cause mortality following myocardial infarction.MethodUsing Danish medical registries, we conducted a nationwide population-based cohort study. We included all patients with first-time myocardial infarction (1995-2014) and identified previous depression as either a depression diagnosis or use of antidepressants. We used Cox regression to compute adjusted mortality rate ratios (aMRRs) with 95% confidence intervals...
March 2, 2017: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/28216698/clinical-application-of-point-of-care-transthoracic-echocardiography-in-perioperative-period
#9
REVIEW
Swaroop Margale, Kurichi Marudhachalam, Sarvesh Natani
Transthoracic echocardiography (TTE) has established its role for diagnosis and management in cardiology and is used by various other specialities in medicine, but it is not routinely practised by anaesthesiologists in the perioperative period including the pre-admission clinic/outpatient clinic. The last decade has seen the emerging role of anaesthesiologist as a 'Perioperative physician'. This review article highlights the potential role and clinical utility, education, teaching and limitations of point of care (POC) TTE modality in perioperative care...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28145035/the-epidemiology-of-long-stay-patients-in-a-university-teaching-hospital
#10
Kim O'Sullivan, Johan Martensson, Raymond Robbins, K J Farley, Doug Johnson, Daryl Jones
BACKGROUND: Patients admitted to acute care hospitals may have multiple co-morbidities, and a small proportion may stay a protracted period. AIMS: To assess the proportion of hospital patients who are long stay (≥14 days), evaluate associations with baseline variables and subsequent in-patient morbidity and mortality. METHODS: Retrospective observational study of patients aged ≥ 18 years staying in hospital for at least 24 hr between 1-7-2013 and 30-6-2014...
February 1, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28133713/prescribing-error-at-hospital-discharge-a-retrospective-review-of-medication-information-in-an-irish-hospital
#11
M Michaelson, E Walsh, C P Bradley, P McCague, R Owens, L J Sahm
BACKGROUND: Prescribing error may result in adverse clinical outcomes leading to increased patient morbidity, mortality and increased economic burden. Many errors occur during transitional care as patients move between different stages and settings of care. AIM: To conduct a review of medication information and identify prescribing error among an adult population in an urban hospital. METHODS: Retrospective review of medication information was conducted...
January 30, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28119313/the-association-between-cognitive-impairment-and-functional-outcome-in-hospitalised-older-patients-a-systematic-review-and-meta-analysis
#12
Peter Hartley, Nathalie Gibbins, Amanda Saunders, Kerry Alexander, Eimear Conroy, Rebecca Dixon, Joseph Lang, Jasmine Luckett, Tim Luddington, Roman Romero-Ortuno
BACKGROUND: in hospitalised older adults, cognitive impairments are common and may be associated with functional outcomes. Our aim was to systematically review this association. METHOD: we systematically searched MEDLINE, CINAHL, AMED and PsycINFO from inception to April 2016. Non-English language studies were filtered out at search stage. All types of studies were considered for inclusion except reviews, conference abstracts, dissertations and case studies. POPULATION: community-dwelling or institutionalised older adults aged 65 years or more, who are acutely hospitalised and have information on history of dementia and/or cognitive scores on admission...
January 23, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28093812/factors-predicting-incidence-of-post-operative-delirium-in-older-people-following-hip-fracture-surgery-a-systematic-review-and-meta-analysis
#13
REVIEW
T O Smith, A Cooper, G Peryer, R Griffiths, C Fox, J Cross
OBJECTIVE: Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS: Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery...
January 17, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#14
Subeer K Wadia, Mark Belkin, Kelsey S Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28077453/state-regulatory-approaches-for-dementia-care-in-residential-care-and-assisted-living
#15
Paula C Carder
PURPOSE: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic. DESIGN AND METHODS: This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment...
January 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/27965823/feasibility-of-a-stepped-wedge-cluster-rct-and-concurrent-observational-sub-study-to-evaluate-the-effects-of-modified-ward-night-lighting-on-inpatient-fall-rates-and-sleep-quality-a-protocol-for-a-pilot-trial
#16
Satyan R Chari, Simon Smith, Alison Mudge, Alex A Black, Mariana Figueiro, Muhtashimuddin Ahmed, Mark Devitt, Terry P Haines
BACKGROUND: Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27943349/problems-with-continuity-of-care-identified-by-community-pharmacists-post-discharge
#17
H T Ensing, E S Koster, P I van Berkel, A A van Dooren, M L Bouvy
WHAT IS KNOWN AND OBJECTIVE: Medication discrepancies are common at hospital discharge, and medication reconciliation is widely endorsed as a preventive strategy. However, implementation is difficult for instance due to the unreliability of patients medication histories. In the Netherlands, community pharmacies are well-informed about their patients' pre-admission medication status which enables thorough post-discharge reconciliation. Our aim was to study the frequency and nature of medication discrepancies, missing patient's knowledge and administrative problems at admission to primary care...
December 10, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27935649/intense-pre-admission-carriage-and-further-acquisition-of-esbl-producing-enterobacteriaceae-among-patients-and-their-caregivers-in-a-tertiary-hospital-in-rwanda
#18
Mathis S E Kurz, Claude Bayingana, Jules M Ndoli, Augustin Sendegeya, Anita Durst, Roland Pfüller, Jean Bosco Gahutu, Frank P Mockenhaupt
OBJECTIVES: To assess the presence and risk factors of intestinal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) among patients admitted to the University Teaching Hospital of Butare and among their attending caregivers, and to analyse the acquisition of ESBL-PE carriage during hospital stay and associated factors. METHODS: We screened 392 patients and their attending caregivers at admission and discharge for ESBL-PE carriage...
February 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#19
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#20
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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